The misunderstood epidemiological determinants of covid 19, problems and solutions
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The document discusses several misunderstood determinants of COVID-19 that have been claimed but lack epidemiological evidence. It questions correlations that have been proposed between COVID-19 outcomes and factors like median age, BCG vaccination rates, religion, and disease burdens. While some correlations appear convincing based on statistics alone, the document argues they ignore important context and exceptions. There have been very few rigorous epidemiological studies of COVID-19 to determine true disease modulators and spread, and many studies have misused non-epidemiological data.
The misunderstood epidemiological determinants of covid 19, problems and solutions
- 1. The Misunderstood Epidemiological Determinants of COVID-19: Problems and Solutions Epidemiology of COVID-19 is illusive. It is less a disease but more a ‘political disaster’ or a ‘Disease of Diagnosis’. BR Singh Pri. Scientist and Head Division of Epidemiology, ICAR-IVRI, Izatnagar-243122 1brs1762@gmail.com
- 2. Synopsis? Prologue! COVID-19, a viral disease, fought with political means for socio-economic gains, will keep on haunting humanity for long. Without doing any epidemiological study on COVID-19 we have determined its modulators and determinants not to win over COVID- 19 but to create misunderstanding to persist for long in inquisitive minds to blur the vision for novel inventions. This presentation deals with COVID-19 in general and misunderstood disease determinants in particular to suggest possible means to win over the disease. As the tip of COVID-19 iceberg is illusion and reality unknown, thus the struggle is endless. brs1762@gmail.com 2
- 3. >150000 people dying due to different disorders daily Deaths per million of Indians per year Food deficiency 21 Fires 22 HIV/AIDS 36 Malaria 40 Drowning 48 Diabetes 104 Suicide 156 Road accidents 171 Tuberculosis 402 Smoking 915 CVD 2820 In India: COVID- 19 Deaths till now 20/ M, Globally 78 Deaths by COVID, ~600 K in 6 months!! California study revealed that there is 0.13% case fatality rate for COVID-19, a little higher than 0.1% for common flu (https://www.vox.com/2020/4/24 /21229415/coronavirus- antibody-testing-covid-19- california-survey). Have you ever feared so much from common flu or the diseases at left and right??? 3brs1762@gmail.com Worldwide daily deaths by cause CVD 48742 Cancer 26181 Respiratory diseases 10724 Lower Respiratory infections 7010 Dementia 6889 Digestive diseases 6514 Neonatal disorders 4887 Diarrheal diseases 4300 Diabetes 3753 Liver Diseases 3624 https://www.weforum.org/agenda/2020/05/how-many-people-die-each-day-covid-19-coronavirus/
- 4. COVIDMania • COVID-19 cases in India till date about a million in last six months may be 10 million by the end of year. • About 27 000 people in India died due to COVID (?????) in last six month and many more may, may be 100 K and about 0.6 million died all over the world. • Have you ever thought: in India 15 million suffer from Malaria per year and 50 million are patients of Filaria (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5034168/). • Every year 100 million poor die due to Dengue globally (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5034168/). • Tuberculosis, a disease of poor, kills 1.5 million people worldwide with 6.4 million new TB cases per year. (https://www.who.int/gho/tb/epidemic/cases_deaths/en/). • In India, every year 440,000 (1205 people daily and more than 50 per hour) die due to TB (https://tbfacts.org/tb-statistics-india/). • In India, every year more than 230,000 people i.e., 630 daily (more than 26 per hour) commit suicide due to one or other reason. (https://economictimes.indiatimes.com/news/politics-and-nation/coronavirus- india-must-do-more-genomic-sequencing-to-enable-faster-decision- making/articleshow/74799884.cms), but no one cared!!!! • Have you or the media or the global leaders ever worried about those poor people or talked too much? No, because they are already big and established pharmaceutical markets but to expand that market further. Every progressive leader wants to have COVID-19. New era of sanitizers, masks, PPE kits, new diagnostics, old drugs repurposed, new drugs launched, vaccines eagerly awaited. 4brs1762@gmail.com
- 5. Global fight with COVID-19 • Fighting COVID-19= Fighting with the unknown • No lineage • No address We have only Data to create panic Panic with motive Motive, economic and political gains (advantage) Advantage of individuals not of masses. Masses are fooled as ever before. 5brs1762@gmail.com
- 6. Overview of Epidemiology of COVID-19 • Ignored since very first day. • Non-epidemiological data, just numbers. • R0 values: Fluctuating (1.5-6.7). • Morbidity: Not yet known, from 0.0003-3.7% (~0.38%) • Mortality: Skewed, 1- 845/ M (~0.015%). • CFR: Biased, 0.0 to 36.2% (~6.16%) • Herd immunity: Illusive (Sweden and California studies, 5-17%). • Immunity after Infection: Short lived (<3 months in ~80%). • Treatments: Taali, Thaali, Shankhnaad (शंखनाद), Deepawali, to hundreds of the known and unknown medicines. • Protection: Mask, Social distancing, Immune boosters, Tonics from Dadi Maa and Nani Maa to Yogi and Jogi Babas, dietary changes and supplements, and Ganda-Tabeej too. • Vaccine(s): Coming soon. 6brs1762@gmail.com
- 7. Epidemiological studies on COVID-19 • Hardly few: That too mostly targeted to see the future of vaccine(s) or clinical trials (in haste) towards repurposing of drugs. • Most of the studies are either – Ecological (not fully ecological too) or – Clinico-pathological (even without proper understanding of pathology) or – Clinical trials of already disputed medicines, – Vaccine trials (in infancy but promising adulthood). • Some studies claim to determine several Modulators and Determinants of the disease as an outcome of play with non- epidemiological data in leisure time under lockdown including – Median age of population, – BCG vaccination status, – Even religion has been linked with morbidity/ mortality and CFR – Several co-morbidities – Socioeconomic factors 7brs1762@gmail.com
- 8. Determinants of the COVID-19 • ‘Politics’ (at all levels starting from non-political WHO to village level), overruled all real determinants of the COVID-19. • Panic: From Tabligi to Mass dislocation, Church to Mosque, Temple to Gurudwara, Sahitan to GOD, Birth to Death, Marriage to Funerals. • Game of numbers. Don’t know for what, that is why it is a political disease or disease of targeted testing. • Information or misinformation war: On scientific platforms (>67K publication within less than six months), publishing and online media, social and anti-social media, socioeconomic and sociopolitical platforms. • The most important determinant is the “the market” made ready to accept just any vaccine, any medicine, either effective for a month, two months, three months or not at all, just safe as “normal Saline”. • Pharmaceuticals: Public and Private, Local-Vocal-Global; Allo:Homeo:Ayush:Unani:Chinese:African:Yoga, and Decoctums and Infusions of all. 8brs1762@gmail.com
- 9. Misunderstood determinants of COVID-19 • Etiology: Controversy over its origin • Spread & Expansion • Determinants and factors of – Morbidity – Mortality – CFR 9brs1762@gmail.com
- 10. Spread of COVID-19 • Communicable through human to human contact, human to animal contact but we don’t know the exact role of animals, foods, meats, vegetables and fruits, and environment (air, water, soil, house flies and other flying swabs). We are fighting with an enemy without knowing even its proper address. • Faeco-oral transmission of Coronaviruses (epidemics known in pigs and humans earlier) but no-one is ready to accept that this may also be important for SARS-CoV-2 also. Probably we have lost the fight in our mind even before fighting it. • Survival of the virus for several weeks in ship cabins documented, still claim that the virus may survive for a few hours or a day or two on common surfaces and air and not spread through news papers. • The virus is detected in water and sewage but we are trying to run away from the facts and happy to live in lockdown, it is like an ostrich keeping its head hiding in sand to think that there is no danger. • Several conflicting statements at level of WHO and different disease control institutions regarding spread of disease my be either due to ill-knowledge about the disease or intentional with some political motives. • All good attempts are made by most of the powerful countries to spread the disease globally through intentional import and export of potential spreaders of the disease by one or other means, and then politicizing the spread in different ways, made it as a political disaster rather than a pandemic of a viral disease. 10brs1762@gmail.com
- 11. Politics of COVID-19 Transmission • Disease not spread through human to human contact, WHO. • Infected people can be contagious well before experiencing symptoms. • "Some modeling studies suggest 40-60% of spread is from people when they didn’t have symptoms”, Ashish Jha, the Brown School of Public Health. • Singapore's Corona-virus task force: Released an animation of demonic spread of COVID-19. • Maria Van Kerkhove (@mvankerkhove, Infectious Disease Epidemiologist; COVID-19 Technical Lead, WHO Health Emergencies Programme tweeted on 8-6-20 “transmission from asymptomatic individuals are difficult to conduct, but the available evidence from contact tracing reported by the Member States suggests that asymptomatically-infected individuals are much less likely to transmit the virus than those who develop symptoms”. • It is not Zoonotic, no role of animals in disease spread (though Cats, dogs, tigers, monkeys suffered and mink transferred infection to half a dozen people???) 11brs1762@gmail.com
- 12. Iceberg of COVID-19 • Except a few isolated attempts no country has attempted to determine the disease iceberg required to estimate the required efforts to contain the disease. • To determine the extent of COVID-19 disease iceberg we need to use antibody tests extensively with well designed sampling plan using one or more tests with high sensitivity and specificity. • We are fighting with the tip of the COVID-19 iceberg and destined to crackdown under lockdowns. • Direct losses due to COVID-19 in form of sick and dead is only tip of the iceberg of economic disease probably leading to economic paralysis after extended lockdowns and partial closures all over the globe which may be killing billions due to our madness to save a few million people already approaching towards there end due to several co-morbidities or have already spent their productive life decades ago. • There is an urgent need to think scientifically, this disease is here to teach the lesson again once taught by Darwin, “Survival of the fittest”. • As the world is ruled mostly by those have enjoyed their productive life but want to rule till their end or they consider themselves endless (Rawans). For those inhumane we are posing humane to display humanity & forget the of the coming generations and poor of this world constituting more than 90% of the humans of the globe. 12brs1762@gmail.com
- 13. Determinants???? Correlation of COVID-19 and Median Age of Nations Cases/ Million 0.153708 Deaths/ Million 0.343575 CFR 0.104797 %Positivity -0.12684 Looks Convincing: 47 countries, median age ≥40 yrs, 13.6% of global population (GP) but 19.7% global COVID-19 cases and 34.4% deaths, 6.76% CFR,138/Million mortality. But nine of such countries had 3.7% GP, have less than 5 deaths per million with 0.7% of cases and 0.25% of deaths. In 37 countries with median age <20 yrs, with 13.8% GP, mortality is 10/ Million. https://www.cia.gov/library/publications/the-world-factbook/fields/343rank.html 13brs1762@gmail.com
- 15. BCG facts???? http://www.bcgatlas.org/index.php • More of Convincing figures: 181 countries with 89.5% GP uses mandatory childhood BCG vaccination, holds 61.5% COVID-19 cases and 45.7% COVID-19 deaths. • 29 countries not mandating BCG use holds 10.5% GP but 38.5 % COVID-19 cases and 54.3% of COVID-19 deaths. • Of the 29 Non-BCG user countries, eight (Australia, Cyprus, Falkland Islands, Iceland, Israel, Liechtenstein, Luxembourg, Vatican City) holding 0.5% of GP, 0.5% of cases but 0.1% of deaths have CFR <2.5. • Six BCG mandating Nations (Guatemala, 22.4; Honduras, 19.4; Hungary, 15.6; Mexico, 15.5; Yemen, 38.8) holding 2.5% GP, 2.8% of COVID cases and 6.9% of deaths have CFR >15%. • 50 BCG user countries having CFR<1%, have hold 7.9% GP, 7% of cases and 7.4% deaths. 15brs1762@gmail.com
- 16. Other disease vaccinations and COVID-19 correlations Use of vaccines (percent population vaccinated)* Cases/M Deaths/M CFR %Positivity BCG -0.1946 -0.51973 -0.23593 0.021372 DPT 0.177646 0.14664 -0.03692 -0.05969 HiB 0.132929 0.143603 -0.01581 -0.04473 Hep B 0.152188 0.05744 -0.06833 -0.04953 RotaVirus 0.051192 -0.06316 -0.11059 -0.06685 Polio 0.190457 0.166946 -0.09053 -0.0704 MCV1 0.206216 0.159052 -0.10478 -0.08398 MCV2 0.208169 0.115188 -0.17265 -0.15418 *https://apps.who.int/gho/data/node.main.A830?lang=en 16brs1762@gmail.com
- 17. Religion of COVID-19????? COVID- 19 Among different nations Correlation of Percent of population following Christians Muslims Hindus Buddhist No Religion Cases/ Million 0.021435 0.035733 -0.0160 -0.10694 -0.01981 Deaths/ Million 0.220773 -0.21897 -0.0802 -0.10571 0.190216 CFR 0.100398 0.027791 -0.0802 -0.1697 0.066224 % Positivity -0.14913 0.209867 -0.0221 -0.03597 -0.07566 Source of religious structure: https://www.pewforum.org/2015/04/02/religious-projection- table/2010/number/all/ https://en.wikipedia.org/wiki/List_of_religious_populations 17brs1762@gmail.com
- 18. Co-morbidities and COVID-19 Burden of different diseases in countries (https://www.who.int/whr/1996/m edia_centre/press_release/en/) COVID-19 parameters Cases/ M Deaths/ M CFR % Positivity TB* -0.23476 -0.25826 -0.08493 -0.03144 HIV* -0.14436 -0.19381 -0.05991 -0.01834 Malaria* -0.19472 -0.21022 -0.04352 -0.01632 Cardivascular Diseases -0.24721 -0.37427 -0.06367 0.183927 Neoplasm 0.163798 0.424877 0.082375 -0.11024 Diabetes 0.185606 -0.06568 -0.08287 0.235771 Smoking -0.16383 -0.09376 -0.06138 -0.10989 18brs1762@gmail.com *That is why we don’t want to control other infectious disease. Who will protect us in future from COVID-19 like diseases? Keep on smoking!!!!
- 19. COVID-19 and Basic amenities and their indicators in Nations COVID Parameters Correlation of COVID-19 with availability of Basic amenities and their indicators in Nations Food deficiency* Water and Sanitation spending Healthy life expectancy Literacy rate #PPP$ Cases/M -0.22351 -0.12252 0.314848 0.22646 0.43915 Deaths/M -0.22378 -0.08841 0.409375 0.256456 0.31057 CFR -0.01284 -0.06721 0.050487 -0.03145 -0.0645 % Positivity -0.02146 -0.05846 -0.15289 -0.16615 -0.1026 19brs1762@gmail.com *Reduction in prosperity is must to curb the COVID-19, that is why you are under lockdown. Keep on fasting to be at safe hand from COVID-19!!!!
- 20. Common Solutions Cure the panic • Live and let live, like most of less-severe diseases, COVID-19 has to live on this earth for long, so we have to accept it as cohabitant on the earth. • Coronization of the world as soon as possible using some less pathogenic and more contagious virus, we may wait till the nature invent such or some scientist(s) do it. • Forgetting at the earliest that some vaccine will come and save the world in real time. Even if one or many are made available in time to come that is destined to fail in containing the disease for years to come. Failing vaccination and repeated outbreaks of age old diseases is lesson to be learned at the earliest. • Treatments for viral diseases are failing since ages, it may be useful for some economically able to afford it but at large always failed. • Respecting the Nature and its forces, and accepting the fact that we are not supreme. • As it is a political disaster, the best strategy is avoiding the politicizing of the numbers of targeted diagnostic tests. And their results and boasting the imaginary successes. • As it is also a disease of diagnosis, another important strategy is either ‘Stop diagnosis’ or ‘Stop public display’ of the numbers now updated in real time. • Displaying numbers appears to be a political strategy to create panic among masses (for one or other gain), the importance should be given to ward of panic of numbers. • As one of the most important determinant of COVID-19 is information or misinformation war in media, on social media and sociopolitical platforms if we can put a break on it or stop for some period instead of lockdown the disease will be controlled in much less time and with less economic implications. 20brs1762@gmail.com
- 21. Epidemiological solutions • Through clinical observations we know the most vulnerable population for COVID-19 morbidity and mortality (aged, people with underlying diseases and compromised immunity), our target should be to save those vulnerable people. • In healthy population, young and adults, the disease is either unapparent or mild, therefore they should be allowed for free movement to work and spend leisure life so that the herd immunity (???) can be created at the earliest. • Natural infections are better creators of immunity than any of the best vaccines thus, we should actively promote that most of the healthy and young population contract the infection time and again for solid and lasting immunity. • Even after natural infections immunity is vanishing fast (UK Studies, in 3 months 83% become un-protected) then it is not possible to predict the efficacy of any vaccine unless repeated frequently, then best is to allow the disease to be endemic. • Though contradicted, the disease also spread through asymptomatically infected people (young and adults) thus their contact with vulnerable be stopped to the maximum. • Educating the people with reality (still unknown) may be other best tool to control the disease because disease is more a created panic than the virus itself. 21brs1762@gmail.com
- 22. https://innovationorigins.com/how- colossal-is-the-corona-iceberg-in-the- netherlands/ https://www.researchgate.net/publication/340183646_COVI D-19_MORTALITY_ICEBERG 22brs1762@gmail.com As the tip is illusion, reality unknown, thus the struggle is endless